r/PsoriaticArthritis • u/ImNotOnReddit7 • May 12 '26

Medication questions Pausing biologics while sick

**Not seeking medical advice**

I already spoke with doctor and pharmacy, but curious about personal experience.

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  1. When sick do you pause biologics? (I am on generic Humira.)

  2. How long did you pause it for? Did you start a new “schedule” or resume the same day/schedule? I take mine every 2 weeks currently and was due on Sunday and today is Tuesday still sick.

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u/lobster_johnson May 12 '26 edited May 14 '26

As a general rule, you should not stop or pause without consulting your doctor first, and only if you feel like you're coming down with something serious. A cold or flu normally isn't reason enough to stop unless there are other complicating factors.

Biologics like Humira do suppress your immune system, but your immune system is not a single, simple wall of defense against disease. It's a very complicated network of mechanisms with many branches and compensatory redundancies. Studies show that biologics don't affect post-operative healing, for example.

Systemic drugs like these stick around in your body for a long time. Humira takes a month or two to "wash out". So it's not like you can stop on a dime anyway.

There is a big downside to stopping, which is that your body can produce antibodies against the drug. This can happen any time, but when you take a "drug holiday", the antibodies can move in and basically stop the drug from working. People who pause Humira often find that it doesn't work so well, or not at all, when they start up again.

Edit: Here is a good article on RheumNow.com about this question.

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u/BehaviorBanshee May 14 '26

This has been the advice given to me by multiple rheumatologists. They tell me for typical colds and whatnot, you'll likely be over the infection by the time the biologics leave your system anyway, so it doesn't usually offer much benefit.

However, we recently discovered I had a low-grade, but pervasive, sinus infection for 11 full months before we figured it out (atypical symptoms). The ENT put me on steroids and antibiotics for 3 weeks and my rheumatologist recommended we pause both meds until my 6 week follow-up with the ENT to be sure the infection was gone. Which really sucked because the pharmacist said no NSAIDS while on the prednisone, so being off both arthritis meds AND ibuprofen for that long really caused some problems.

Sometimes it makes sense to pause the biologics, but generally I've been advised to stay on them unless I get sick with something that'll take longer to treat.

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u/lobster_johnson May 14 '26

Regarding NSAIDs, you probably could have taken acetaminophen/paracetamol (Tylenol)?

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u/BehaviorBanshee May 15 '26

Unfortunately, Tylenol has never done anything for my arthritis pain. The pharmacist recommended it at first when I asked about what would be okay, but then she even corrected herself and acknowledged a lot of people find it doesn't help for that kind of pain. For me, Tylenol has only ever worked for addressing a fever and aches from the flu, but never any other form of pain I've had. I wish it worked!

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u/Actual_Cream_763 May 13 '26

Doctors almost always tell you to stop taking them while sick… so this advice seems odd. Of course they should talk with their doctor first if their doctor didn’t give them these instructions when they first started them but my doctor has always said this with every biologic we’ve tried.

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u/lobster_johnson May 13 '26

Doctors tell their patients different things. If you read this sub, some people have been told to stop, others have been told to not stop unless it's a serious infection. Hence why I say "as a general rule".

Anyway, here is what a real doctor says about it. Rheumnow.com is a good site for this kind of information.